An Overlooked Cause Of Hospital Death

Medical Journal Reports Blood Clots Are Most Common Cause Of Preventable Death In Patients

(CBS)  It's the most common preventable death in the hospital.

"It's staggering to think about the number of patients who have preventable events related to clots in their legs, which eventually become fatal," said Dr. Nick Morrissey, a vascular surgeon at New York-Presbyterian Hospital.

Blood clots that travel to the lungs kill 25,000 Americans every year.

And a new study out in the Lancet says only about half of the hospitalized patients at risk are being treated to prevent them, CBS News medical correspondent Dr. Jon LaPook reports.

LaPook asked former hospital patient Lorelai Fredheim: "Did anybody say to you, 'there's a risk you would get a blood clot?'"

"Not at all," Fredheim said. "Not at all."

She developed a potentially deadly blood clot following minor knee surgery.

"It definitely would have killed me," she said.

Prevention is usually simple. Using compression stockings to help circulation, blood thinners, or just walking around after a procedure.

"I think we're not doing a good enough job and we certainly can do better," Morrissey said. "Just like we address infection control and infection prevention, we should be addressing in a formalized way, prevention of development of clots."

What can you do to keep yourself or your loved ones out of this danger?

If you're in the hospital, LaPook said, get out of bed if you can, and ask your doctor if blood thinners are a good idea.

[rgpowell2]

You forgot to include insurance companies that will not athorize the drugs to prevent this problem! Their opinion is "That they are not needed".

[me4prezz]

This is standard practice in the hospital I work for. Every patient is provided with DVT (deep vein thrombosis), a.k.a. blood clot in leg, and GI (gastrointestinal) prophylaxis as standard care. GI is usually with Nexium or Pepcid and DVT with either TEDS (thromboembolic deterrent stockings), SCDs (sequential compression devices), or Coumadin, Lovenox or even heparin. However, some people are not able to take blood thinners, so you really need to ask your doctor.

And yes, I had a blood clot in my lung, otherwise known as a pulmonary embolism, while in the hospital following emergency surgery and sometimes they happen regardless of treatment. Request something for prevention and you will get it. Just be an informed patient.

[alphaa10-2009]

Dr. Morrissey said, "I think we''re not doing a good enough job and we certainly can do better... Just like we address infection control and infection prevention, we should be addressing in a formalized way, prevention of development of clots."
---
Neither infection control (MRSA) nor clot control is a priority at most hospitals. Hospitals and medical excellence, in particular, have suffered under the HMOs and their reign of error.

"Sorry about that!" is what most people hear if a relative succumbs to something which clearly should not happen.

Clots arise from a wide variety of conditions, but have in common a blockage or sharp reduction of blood flow. Even cardiac arrhythmias are dangerous for this reason.

Everyone is at risk, regardless of age. Youth is only a predictor of surviving a clot, not immunity from clots.

[jeff-fla]

I have know this for sometime. I was in an industrial accident and lots parts of one leg. Since then I have had a few other complications. I tell my Dr. that I am worried about blood clots. I get told "I''m the Dr. I know what to do, so stop worrying and listen to me." That almost killed me once. How does an informed person ask there Dr. to do something that the Dr. is not doing?

[dnamj]

My sister has been in the hospital all week with a stroke (she''s doing much better now). Anyway, as soon as they knew she would be in bed for a long time, they started a regular injection of Heparin (blood thinner). They said this was standard care for all patients now. This is the UW Medical center in Seattle.

[lf1952]

The comments that this is the standard of care almost everywhere are exactly correct. Over the last 5 YEARS, there has been a terrific effort to educate health care providers and to establish ant-DVT protocols.

The concept that compression devices are enough is also questionable, unless there are reasons not to use an heparin or low moecular weight heparin.

I have wonder where the researchers have been, or where they got the data from, to have missed this. Even small community hospitals generally have excellent anti-DVT programs.

No one can deny that many practitioners are very concerned about this wholesale use of anti-coagulants, which have their own set of risks - however, because of the potential for DVT''s, these risks are usually worth the benefit. That decision must be made by the physician caring for the patient on an individual basis.

Regardless, PLEASE do NOT "get out of bed" if your practitioner has told you otherwise, for fear of a DVT!

[travelvet]

In 2003, I suffered from multiple blood clots to my entire lower extremities. One doctor ignored the obvious diagnosis and diagnosed me with a muscle strain. Not only were both legs swollen, but I suffered stomach and back pain. The next doctor diagnosed kidney stones and prescribed antibiotics. The real diagnosis was renal colic from blood clots lodged in my urinary tract and forced an infection and bleeding back into my kidney.

Left with acute kidney failure, I spent 11 days inpatient, 3 months bedridden and severely anemic. I endured failed kidney stents with 2 stomach surgeries. Every surgery began with more blood clots in my legs and more surgical complications afterwards.

I''m lucky to be alive today despite the IVC filter permanently implanted in me, the years of recovery, the total loss of my right kidney, and a lifetime prescription on Coumadin. I wish now that these doctors recognized the real diagnosis in time to save me from going through 5 surgeries. I truly suffered from putting faith in the medical profession.

For the next 20 years, I will be paying the cost of the medical bills. I will never give doctors that much power. All doctors%u2019 histories are investigated and extensive research done for any diagnosis given. Just because a doctor has a medical degree and is allowed to practice...doesn''t mean that he or she knows what they''re doing. Blind faith is mere foolishness. Doctors make more mistakes than any other profession.

[travelvet]

In 2003, I suffered from multiple blood clots to my entire lower extremities. One doctor ignored the obvious diagnosis and diagnosed me with a muscle strain. Not only were both legs swollen, but I suffered stomach and back pain. The next doctor diagnosed kidney stones and prescribed antibiotics. The real diagnosis was renal colic from blood clots lodged in my urinary tract and forced an infection and bleeding back into my kidney.

Left with acute kidney failure, I spent 11 days inpatient, 3 months bedridden and severely anemic. I endured failed kidney stents with 2 stomach surgeries. Every surgery began with more blood clots in my legs and more surgical complications afterwards.

I''m lucky to be alive today despite the IVC filter permanently implanted in me, the years of recovery, the total loss of my right kidney, and a lifetime prescription on Coumadin. I wish now that these doctors recognized the real diagnosis in time to save me from going through 5 surgeries. I truly suffered from putting faith in the medical profession.

For the next 20 years, I will be paying the cost of the medical bills. I will never give doctors that much power. All doctors%u2019 histories are investigated and extensive research done for any diagnosis given. Just because a doctor has a medical degree and is allowed to practice...doesn''t mean that he or she knows what they''re doing. Blind faith is mere foolishness. Doctors make more mistakes than any other profession.

[travelvet]

In 2003, I suffered from multiple blood clots to my entire lower extremities. One doctor ignored the obvious diagnosis and diagnosed me with a muscle strain. Not only were both legs swollen, but I suffered stomach and back pain. The next doctor diagnosed kidney stones and prescribed antibiotics. The real diagnosis was renal colic from blood clots lodged in my urinary tract and forced an infection and bleeding back into my kidney.

Left with acute kidney failure, I spent 11 days inpatient, 3 months bedridden and severely anemic. I endured failed kidney stents with 2 stomach surgeries. Every surgery began with more blood clots in my legs and more surgical complications afterwards.

I''m lucky to be alive today despite the IVC filter permanently implanted in me, the years of recovery, the total loss of my right kidney, and a lifetime prescription on Coumadin. I wish now that these doctors recognized the real diagnosis in time to save me from going through 5 surgeries. I truly suffered from putting faith in the medical profession.

For the next 20 years, I will be paying the cost of the medical bills. I will never give doctors that much power. All doctors%u2019 histories are investigated and extensive research done for any diagnosis given. Just because a doctor has a medical degree and is allowed to practice...doesn''t mean that he or she knows what they''re doing. Blind faith is mere foolishness. Doctors make more mistakes than any other profession.

[abigail70]

The seriousness of blood clots is without doubt. I worked exclusively in Southeastern hospitals for about 12 years throughout the 90''s & early 2K''s (via agencies). Starting in the late 90''s, every hospital I worked in made prevention of clots a huge concern, & this was always part of a pt''s treatment, be it drugs, education, or a combination of both. Lovenox was handed out (injected) like candy, & every pt was taught that the drug was to prevent blood clots, which could, for example, go to the brain, heart, lungs or legs, & cause problems such as CVA%u2019s, MI%u2019s & DVT. Not every pt was able to receive blood thinners, but they were always taught risk & prevention. This was the *standard of care* in the 30+ facilities I worked in, & I find articles such as this grossly inaccurate. If a pt had a procedure such as a "minor knee surgery", she definitely would have been warned about the risk. Never say never, but I believe most who deny being informed have just forgotten. Much is going on when one is hospitalized, or even having an outpt procedure, & countless times someone indicated something was never mentioned to them when I know for a fact it was. Granted, sometimes education comes in the form of documents folks receive & sign while under treatment, but pts must assume responsibility for being their own best advocate. I''m not blaming those who deny being informed, however treatment of clots is much riskier & time consuming than prevention, thus prevention is the standard of care.

[deemsnyd]

I work in a small community hospital. I am not in medical care, I work in one of the offices, and even I constantly hear about DVT protocol. This article is good as far as informing patients about DVT, but seems a bit alarmist. If even a small, rural hospital like ours is on top of this, it seems unlikly to me that the title of this piece was meant for anything other than "attention grabbing".

[slim1h2o]

A similar dynamic defined much of NAZI Germany. Nazi Youth manuals proclaimed that %u201Cnutrition is not a private matter!%u201D %u201CGemeinnutz geht vor Eigennutz%u201D - essentially, all for one, one for all - was the rallying slogan of the Nazi crackdown on smoking, the first serious anti-tobacco campaign of the 20th century. The argument was that the infirmed were too much of a drain on the SOCIALIST economy.

Posted by frankIy6 at 09:36 AM : Feb 01, 2008

Yup,,,thats exactly what we have become,,Nazi Germany. ......Well said! Seig Heil!!

[aldewitt-2009]

Oh please! Socialism? Nazism? Give me a break.
This is a story about Deep Venous Thrombosis or DVT. Its a silent and deadly killer and it almost claimed my wife''s life. The little podunk hospital where she was never treated her for the condition even though it is one of the most common complications. Fortunately, through no fault of the hospital, she survived and went on to lead a productive life. But hudreds die every year. I salute the idea that hospitals should be more vigilant in protecting the health of their patients.

And, if you guys understood anything about smoking and health, or health care for that matter, you''d support a total ban on smoking. As a former respiratory therapist who''s seen thousands of lives destroyed by this weed, I can only pity the ignorance that argues for the "right" to smoke. Just checked the constitution: it isn''t in there.

[ozziepooh90]

aldewitt ( and everyone else )
first of all this article has nothing to do with smoking so why even bring it up. It is getting so over blown about smoking!!!!! If people want to smoke let them. Fine stop smoking in bar and everywhere else. But when the money stops coming in from smokers, watch out because the government will find something else to tax and/or ban.

[emma915]

frankly6
What do you do? Write one opinion, then post it on every article''s comment section?

[tlparp]

This is not new news. This article is based on a study published in The Lancet, and the study was done in British hospitals. I work in healthcare in a relatively rural area in Virginia, and know that in the past several years there has been a huge push to bring the risk of DVT into the forefront. March is DVT Awareness Month in the US, with many hospitals and health care organizations providing inservices to staff, as well as public service announcements and seminars available to the public. In our health system, there is a DVT protocol, and EVERY patient admitted to the hospital is screened for risk for DVT, and if they meet the criteria, they are started on prophylactic treatment - either compression stockings, meds, or a combination.

[aldewitt-2009]

Ozziepooh:

I did not bring up the subject of smoking, I was responding to the rather lame attempt to correlate smoking bans with DVT prophylaxis and nazism, which I found to be a stretch. Someone else raised the issue, I just responded to it.

But, strange as it may seem, DVT is linked to smoking. Smoking damages blood vessels and impairs circulation. A smoking history is an indication of increased risk for DVT.

But you are right about taxes. As long as there are people dumb enough to smoke, I can save a lot of money on taxes. Once they stop, I''ll have to start picking up the tab. Oh well..

[abigail70]

Go ahead and support a ban on smoking, Poindexter. Next, consider voting on a ban relating to anything unhealthy you ingest or absorb, because the aforementioned is only the first step. Regarding DVT, I''m glad your wife is well, truly. However, a huge majority of facilities absolutely do everything they can to educate and prevent issues related to blood clots. No, we can''t assume that it''s done in every single hospital in the country, but there''s been an incredible push to prevent these, and the article lies when it infers otherwise.

[jon2012-2009]

frankly6
What do you do? Write one opinion, then post it on every article''''s comment section?
Posted by Emma915 at 11:16 AM : Feb 01, 2008

That''s exactly what he does. And it''s just typical Republican trash, excuse my french.

[beehive21-2009]

Take two asprin if you feel cramps in leg ,cramps go away in 2-3 min.,repeat as necessary .